1. Safety and Efficacy of Apixaban Versus Warfarin in Patients With Advanced Chronic Kidney Disease
- Author
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Ashley L Casey, Kristina A Dupre, Joseph H. Schafer, and Britta A Staubes
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,medicine.medical_treatment ,Population ,Warfarin ,Atrial fibrillation ,030204 cardiovascular system & hematology ,medicine.disease ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Pharmacology (medical) ,In patient ,Apixaban ,cardiovascular diseases ,030212 general & internal medicine ,business ,education ,Dialysis ,Kidney disease ,medicine.drug - Abstract
Background: Because of a lack of comparative data on anticoagulant use in the advanced chronic kidney disease (CKD) population, guidelines recommend warfarin for atrial fibrillation and venous thromboembolism (VTE) treatment in these patients. However, apixaban has specific dosing recommendations in CKD leading to use in clinical practice. Objective: To evaluate major bleeding, stroke, and thromboembolism rates in patients with CKD stage 4, stage 5, and dialysis on apixaban or warfarin therapy. Methods: This was a retrospective cohort study of patients with advanced CKD receiving apixaban or warfarin. The primary outcome was the occurrence of major bleeding at 3 months after enrollment. Secondary outcomes included occurrence of major bleeding, occurrence of ischemic stroke, and recurrence of VTE at 3 to 6 and 6 to 12 months. Results: A total of 604 patients were included in the analysis. The percentage of apixaban and warfarin patients with a major bleed at 0 to 3, 3 to 6, and 6 to 12 months were 8.3% versus 9.9% ( P=0.48), 1.4% versus 4% ( P=0.07), and 1.5% versus 8.4% ( P
- Published
- 2018